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Perioperative Risk Factors for Postoperative Pulmonary Complications After Minimally Invasive Esophagectomy

Xiaoxi Li1, Ling Yu1, Miao Fu1

  • 1Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Anesthesiology, Peking University Cancer Hospital & Institute, Beijing, China.

International Journal of General Medicine
|February 20, 2024
PubMed
Abstract

Insights

Postoperative pulmonary complications (PPCs) after minimally invasive esophagectomy (MIE) affect 25.2% of patients. Key predictors include male sex, BMI, COPD, neoadjuvant chemoradiotherapy, low albumin, and perioperative transfusion.

Area of Science:

  • Thoracic Surgery
  • Surgical Oncology
  • Pulmonary Medicine

Background:

  • Postoperative pulmonary complications (PPCs) are the most frequent complication following esophagectomy.
  • PPCs significantly worsen patient prognosis after esophagectomy.
  • Minimally invasive esophagectomy (MIE) is increasingly utilized, necessitating an understanding of its specific complication risks.

Purpose of the Study:

  • To identify perioperative risk factors associated with PPCs after McKeown MIE.
  • To develop a predictive model for PPCs in MIE patients.

Main Methods:

  • Retrospective analysis of 767 patients undergoing McKeown MIE (thoracoscopy and laparoscopy).
  • Evaluation of patient characteristics, perioperative data, and postoperative complications.
  • Logistic regression analysis to determine independent predictors of PPCs.

Main Results:

  • The incidence of PPCs was 25.2% (193/767).
  • Independent predictors identified: male sex, elevated body mass index (BMI), chronic obstructive pulmonary disease (COPD), neoadjuvant chemoradiotherapy, low postoperative albumin concentration, and perioperative transfusion.
  • The predictive model demonstrated moderate accuracy (AUC = 0.671).

Conclusions:

  • Male sex, BMI, COPD, neoadjuvant chemoradiotherapy, postoperative albumin levels, and perioperative transfusion are significant independent predictors of PPCs following MIE.
  • These findings can inform risk stratification and targeted preventative strategies for MIE patients.
Keywords:
esophageal cancerminimally invasive esophagectomyperioperative risk factorspostoperative pulmonary complicationspredictive model

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